Northern Ontario hospital prepares should COVID-19 hit First Nations

One of the regional hospitals that will play a key front-line role if COVID-19 hits remote northern First Nations is freeing up beds and ordering additional ventilators in preparation.  

The Thunder Bay Health Sciences Centre would not only serve the 100,000 residents of the city in the event of an outbreak, but also deal with any critical cases from First Nations in its region. That includes smaller hospitals in places like Kenora, Dryden, Fort Frances and Sioux Lookout — which also serve a large Indigenous population.  

Dr. Stewart Kennedy, the executive vice-president of medicine and academics at the Thunder Bay Regional Health Sciences Centre, said the hospital has already placed an order for 30 additional ventilators to add to the 25 it already has on hand. 

"We are absolutely prepared for both Thunder Bay and the region. The unknown question mark is what impact the community spread is going to have," said Kennedy. 

"We expect the vast majority of critically ill patients to transfer here to Thunder Bay...We are confident we have the capacity, both human resources as well as mechanical resources, to meet the needs."

Kennedy said the hospital has 22 beds in its ICU and a 395-bed capacity. The hospital currently has about 300 beds occupied, but it's cancelled elective surgery and other non-essential services with the hope of eventually freeing up between 150 and 200 beds.

"Because our capacity is down, we have the ability to redeploy a good number of our nurses," he said. 

Kennedy said the hospital's regional critical care team is in daily morning communication with teams in Kenora, Dryden, and Fort Frances to keep abreast of the needs for each area. If at any time those smaller centres can't keep up with the flow of demand, or need specialized expertise, patients would be flown to Thunder Bay for treatment, he said.

Crystal Pirie, senior director of Indigenous collaboration at the hospital, said there is a constant information flow between the hospital and First Nation organizations and the health authority in the region.

"They are aware of what we are doing at the hospital and they are aware of what to expect should they have to be sent here," said Pirie.

Kennedy said the hospital's incident management team meets twice a day, sometimes for three or four hours, and during those talks they get input from officials with the municipal, provincial and federal governments. 

Eabametoong Chief Harvey Yesno, whose community is served by the Sioux Lookout regional hospital and who has seen patients die on the tarmac waiting to be flown to Thunder Bay, has raised concerns that the layered jurisdiction could delay timely treatment of COVID-19 cases.   

Kennedy said Ontario's decision to invoke a state of emergency will prevent these types of issues for occurring.

While First Nation communities have nursing stations and clinics run under federal jurisdiction, Kennedy said health officials from all levels are working in tandem to deal with any potential issues that might arise.

"We have a lot of numbers on the scoreboard and if there is any sort of hold up we can get to the next level of approval," he said. 

"If there are any hiccups in the system, which there could be depending on volume, we are ready to react and change those and address those issues within an hour.".

WAHA also ordered ventilations

In another part of Ontario, the Weeneebayko Area Health Authority, which serves First Nations along the province's James Bay and Hudson Bay coast, is also starting preparations. The health authority's regional hospital in Moose Factory has ordered two portable ventilators to add to its existing inventory of two, and they are expected to arrive in two to three weeks, according to the health authority.

The Moose Factory hospital does not have an ICU and any patients needing care would be flown to the nearest hospital with available space — either Sudbury, Kingston or Ottawa.

"Our hope is that with all the efforts we and each of the communities are doing, we will flatten the curve enough that no one needs to be put on a ventilator," said a statement from WAHA.